STUDY - Technical - New Dacian's Medicine
Agitation
(Classical / Allopathic Medicine)
Agitation refers
to a state of hyperarousal, increased tension, and
irritability that can lead to confusion, hyperactivity, and
overt hostility. This common sign can result from any one of
various disorders, pain, fever, anxiety, drug use, withdrawal,
or a hypersensitivity reaction. It can arise gradually or
suddenly and can last for minutes or months. Whether it's mild
or severe, agitation worsens with increased fever, pain,
stress, or external stimuli.
Agitation alone
merely signals a change in the patient's condition. However,
it's a useful indicator of a developing disorder when
considered with the patient's history, current status, and
other findings.
HISTORY:
Ask the patient-specific questions to determine the number and quality of agitation-induced behaviors, such as emotional lability, confusion, memory loss, hyperactivity, and hostility.
Ask the patient to detail his current diet and known allergies.
Ask the patient if he's being treated for any illnesses. Has he had a recent infection, trauma, stress, or changes in sleep patterns?
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient-specific questions to determine the number and quality of agitation-induced behaviors, such as emotional lability, confusion, memory loss, hyperactivity, and hostility.
Ask the patient to detail his current diet and known allergies.
Ask the patient if he's being treated for any illnesses. Has he had a recent infection, trauma, stress, or changes in sleep patterns?
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
PHYSICAL
ASSESSMENT:
Take the patient's vital signs.
Perform a basic neurologic assessment for future comparison.
Check for signs of drug abuse, such as needle tracks and dilated pupils.
Take the patient's vital signs.
Perform a basic neurologic assessment for future comparison.
Check for signs of drug abuse, such as needle tracks and dilated pupils.
SPECIAL
CONSIDERATIONS:
Because agitation can be an early sign of many different disorders, continue to monitor the patient's vital signs and neurologic status while the cause is being determined. Eliminate stressors, which can increase agitation. Provide adequate lighting, maintain a calm environment, and allow the patient ample time to sleep. Ensure a balanced diet, and provide vitamin supplements.
Remain calm, nonjudgmental, and nonargumentative. Use restraints according to your facility's policy and only when absolutely necessary because they may increase agitation.
Because agitation can be an early sign of many different disorders, continue to monitor the patient's vital signs and neurologic status while the cause is being determined. Eliminate stressors, which can increase agitation. Provide adequate lighting, maintain a calm environment, and allow the patient ample time to sleep. Ensure a balanced diet, and provide vitamin supplements.
Remain calm, nonjudgmental, and nonargumentative. Use restraints according to your facility's policy and only when absolutely necessary because they may increase agitation.
PEDIATRIC
POINTERS:
A common sign in children, agitation accompanies the expected childhood diseases as well as more severe disorders that can lead to brain damage, hyperbilirubinemia, phenylketonuria, vitamin A deficiency, hepatitis, frontal lobe syndrome, increased intracranial pressure, and lead poisoning.
In neonates, agitation can stem from alcohol or drug withdrawal if the mother abused these substances.
When evaluating an agitated child, remember to use words that he can understand and remember to look for nonverbal clues. For example, if you suspect that pain is causing agitation, ask him to tell you where it hurts, but be sure to watch for other indicators, such as wincing, crying, or moving away.
A common sign in children, agitation accompanies the expected childhood diseases as well as more severe disorders that can lead to brain damage, hyperbilirubinemia, phenylketonuria, vitamin A deficiency, hepatitis, frontal lobe syndrome, increased intracranial pressure, and lead poisoning.
In neonates, agitation can stem from alcohol or drug withdrawal if the mother abused these substances.
When evaluating an agitated child, remember to use words that he can understand and remember to look for nonverbal clues. For example, if you suspect that pain is causing agitation, ask him to tell you where it hurts, but be sure to watch for other indicators, such as wincing, crying, or moving away.
AGING ISSUES:
Any deviation from an older person's usual activities or rituals may provoke anxiety or agitation. An environmental change, such as a transfer to a nursing home or a visit from a stranger in the patient's home, may trigger agitation.
Any deviation from an older person's usual activities or rituals may provoke anxiety or agitation. An environmental change, such as a transfer to a nursing home or a visit from a stranger in the patient's home, may trigger agitation.
PATIENT
COUNSELING:
Instruct the patient on what to expect from diagnostic testing, which may include a computed tomography scan, skull X-rays, magnetic resonance imaging, and blood studies, which may be performed to determine the source of agitated behavior.
Instruct the patient on what to expect from diagnostic testing, which may include a computed tomography scan, skull X-rays, magnetic resonance imaging, and blood studies, which may be performed to determine the source of agitated behavior.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)